Medical Specialties Commons^™

Chronic Renal Disease Is More Prevalent In Patients With Hemolytic Uremic Syndrome Who Had A Positive History Of Diarrhea, Ajay P. Sharma, Guido Filler, Prabo Dwight, William F. Clark

Paediatrics Publications

Many uncontrolled studies and a subsequent meta-analysis suggest that hemolytic uremic syndrome (HUS) with a positive history for diarrhea is associated with a significant increase in chronic renal disease. Two recent controlled studies that followed children with this type of HUS after Escherichia coli O157:H7 outbreaks, and where the controls were selected from a group exposed in the outbreak, gave conflicting results. To clarify this apparent difference, we retrospectively compared a cohort of 30 children with sporadic diarrhea-positive HUS with 30 healthy controls who had no history of bloody diarrhea or HUS and who had similar age and gender. Significantly …

Ppar_2 Expression In Growth Plate Chondrocytes Is Regulated By P38 And Gsk-3, Lee-Anne Stanton, Jennifer Ruizhe Li, Frank Beier

Paediatrics Publications

Although peroxisome proliferator activated receptor (PPAR)_ remains a critical regulator of preadipocyte differentiation, new roles have been discovered in inflammation, bone morphogenesis, endothelial function, cancer, longevity and atherosclerosis. Despite the demonstration of PPAR expression in chondrocytes, its role and the pathways affecting its expression and activity in chondrocytes remain largely unknown. We investigated the effects of PPAR activation on chondrocyte differentiation and its participation in chondrocyte lipid metabolism. PPAR2 expression is highly regulated during chondrocyte differentiation in vivo and in vitro PPAR activation with troglitazone resulted in increased Indian hedgehog expression and reduced collagen X expression, confirming previously described roles …

A Review Of Autoimmune Diseases Associated With Cancer, Patricia Tai, Edward Yu, Kurian Joseph, Thomas Miale

Oncology Publications

The focus of this review is on the relationships between autoimmune diseases and cancer from two closely related perspectives: 1.Those autoimmune diseases which are often associated with malignancies. 2.Those prevalent cancers which may increase the risks of developing autoimmune disorders. The review concludes with a brief discussion of some selected innovative approaches to cancer immunotherapy.

Aging, Physical Activity And Arthritis Part 1, Albert W. Taylor

Canadian Centre for Activity and Aging Presentations

No abstract provided.

Aging, Physical Activity And Arthritis Part 2, Albert W. Taylor

Canadian Centre for Activity and Aging Presentations

No abstract provided.

Exercise Prescription For Osteoporosis, Lora Giangregorio

Canadian Centre for Activity and Aging Presentations

No abstract provided.

Hypertonic Saline For Peri-Operative Fluid Management, Vivian Mcalister, Karen E. A. Burns, Tammy Znajda, Brian Church

Surgery Publications

BACKGROUND: Fluid excess may place patients undergoing surgery at risk for various complications. Hypertonic saline (HS) maintains intravascular volume with less intravenous fluid than isotonic salt (IS) solutions, but may increase serum sodium.

OBJECTIVES: To determine the benefits and harms of HS versus IS solutions administered to patients undergoing surgery.

SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library) Issue 1, 2009; MEDLINE (1966 to 2009); EMBASE (1980 to 2009); LILACS (to August 2009) and CINAHL (1982 to 2009) without language restrictions.

SELECTION CRITERIA: We included randomized clinical trials where HS was compared to …

Adaptive Radiation Therapy Of Prostate Cancer, Ning Wen

Wayne State University Dissertations

ART is a close-loop feedback algorithm which evaluates the organ deformation and motion right before the treatment and takes into account dose delivery variation daily to compensate for the difference between planned and delivered dose. It also has potential to allow further dose escalation and margin reduction to improve the clinical outcome. This retrospective study evaluated ART for prostate cancer treatment and radiobiological consequences. An IRB approved protocol has been used to evaluate actual dose delivery of patients with prostate cancer undergoing treatment with daily CBCT.

The dose from CBCT was measured in phantom using TLD and ion chamber techniques …

Identification Of Neuroblastoma And Its Prognostic Markers Using Raman Spectroscopy, Rachel Kast

Wayne State University Dissertations

Introduction: Neuroblastoma is the most common cancer of infancy. It is one of several peripheral nervous system tumors, including ganglioneuroma, peripheral nerve sheath tumor, and pheochromocytoma. It is commonly situated on the adrenal gland. It displays similar histology to other small round blue cell tumors, including non-Hodgkin lymphoma, rhabdomyosarcoma, and Ewing sarcoma. One method of judging neuroblastoma aggressiveness uses tumor histology factors, including mitosis-karyorrhexis index, Schwannian stromal development, degree of differentiation, and patient age. Tumor aggressiveness can also be judged based on the amplification of certain genes, including MYCN. Raman spectroscopy is a physics-based method which identifies the biochemical …

Children's Mercy Hospital Annual Report 2009, Children's Mercy Hospital

Children's Mercy Annual Reports

Annual report for The Children's Mercy Hospital in Kansas City MO, a pediatric medical center.

Egfr/Met Association Regulates Egfr Tki Resistance In Breast Cancer, Kelly L. Mueller, Zeng-Quan Yang, Ramsi Haddad, Stephen P. Ethier, Julie L. Boerner

Wayne State University Associated BioMed Central Scholarship

Abstract

Breast cancers show a lack of response to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), despite 30% of tumors expressing EGFR. The mechanism of this resistance is unknown; however, we have recently shown that Met kinase activity compensates for loss of EGFR kinase activity in cell culture models. Met has been implicated in the pathogenesis of breast tumors and therefore may cooperate with EGFR for tumor growth. Here we have found that EGFR phosphorylation and cell proliferation is in part regulated by Met expression. In addition, we found that Met constitutive phosphorylation occurred independent of the Met …

Hyperandrogenism And Obesity, Amit M. Deokar, Shawn J. Smith, Amanda J. Goodwin, Hatim A. Omar

Pediatrics Faculty Publications

This chapter has a two-fold objective. One, ti addresses the association of hyperandrogenism and obesity and the complex metabolic derangements that are part of the problem. Clinical management of these co-morbidities is challenging and complex. Second, this chapter will aid health care providers with the key features to an early diagnosis and intervention to decrease the morbidities in the short as well as long term. Method: Systematic review of articles and information on the topic of interest that were published in the last 15 years. Conclusion: Obesity and hyperandrogenism are integral parts of Metabolic Syndrome/Polycystic Ovarian Syndrome (PCOS)/Hyperandrogenism, Insulin resistance, …

Incidence Of Post Dural Puncture Headache Following Caesarean Section Under Spinal Anaesthesia At The Aga Khan University Hospital, Nairobi, Edna Gisore, Vitalis Mung’Ayi, Sharif T.

Anaesthesiology, East Africa

Background: Post dural puncture headache can be a debilitating complication of subarachnoid anaesthesia for a new mother. Successful management of post dural puncture headache requires adherence to clear policies and protocols with close follow up of patients by an experienced obstetric anaesthetist.

Objectives: To examine the cumulative incidence and severity of post dural puncture headache in obstetric patients who consented for spinal anaesthesia for Caesarean section.

Design: Prospective cohort study.

Subjects: All women who underwent Caesarean sections under spinal anaesthesia and fulfilled the inclusion criteria.

Setting: Aga Khan University Hospital, a teaching and referral hospital in Nairobi, Kenya.

Results: …

Intussusceptions In Adults: Clinical Features And Operative Procedures, Ziaur Rehman, Abdul Rehman Alvi, Salma Khan

Section of General Surgery

Objective: To determine the clinical presentation and treatment outcomes of adult patients with intussusceptions.
Study Design: Case series.
Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1988 to December 2008.
Methodology: Medical records of patients with diagnosis of intussusceptions in adults (above 15 years of age) from January 1988 to December 2008 were retrieved through ICD 9 coding system. Patients with complete records were included in the study and those with incomplete medical record or under 30 days follow-up were excluded. Data was analyzed on SPSS version 16. The treatment outcomes were hospital stay, 30 …

Hepatic Vein And Inferior Vena Caval Thrombus Extending Into The Right Atrium: A Rare Complication Of Amoebic Liver Abscess, Ziaur Rehman, Abdul Rehman Alvi, Shahida Bibi

Section of General Surgery

Amoebic liver abscess is an endemic in developing countries but few cases of associated vascular complications have been reported. The authors report a very rare vascular complication of hepatic veins and inferior vena caval (IVC) thrombosis extending into the right atrium in a young male with large amoebic liver abscess. Optimal result was achieved with early diagnosis on CT scan, percutaneous drainage of abscess, intravenous metronidazole, peri-operative anticoagulation, sternotomy and thrombectomy.

Prevalence Of Hepatitis B And C Viral Infections In Pakistan: Findings Of A National Survey Appealing For Effective Prevention And Control Measures, H Qureshi, K M. Bile, Rashid Jooma, S E. Alam, H U R. Afridi

Section of Neurosurgery

A prevalence survey on hepatitis B and C infections was carried out to obtain national estimates and assess epidemiological dynamics and underlying risk factors. Overall prevalence of hepatitis B surface antigen (HBsAg) and anti-hepatitis C virus (HCV) of 2.5% and 4.8%, respectively, reflected a combined infection rate of 7.6% in the general population, consistent with an ongoing high burden of chronic liver disease (CLD). There was significant association of these viral infections with a range of risk factors led by reuse of syringes. These findings validate currently implemented strategies by the national programme for the control of hepatitis viral infections, …

The Global Pediatrician: Is There Such A Person, Or Can There Be?, Robert Armstrong

Paediatrics and Child Health, East Africa

As pediatricians, our concern for the health of children and youth starts with our individual encounters with patients and their families and extends to the community in which they live and the broader systems of society that influence their health. This concept of a pediatrician is captured in one of the “bibles” of our profession and in the words of Richard Behrman when he defines pediatrics as being “concerned with the health of infants, children, and adolescents, their growth and development, and their opportunity to achieve full potential as adults.”¹ Health, growth and development, and opportunity as adults encompass …

Predictors Of Emotional Problems And Physical Aggression Among Children Of Hong Kong Chinese, Mainland Chinese And Filipino Immigrants To Canada, Morton Beiser, Hayley Hamilton, Joanna Anneke Rummens, Jacqueline Oxman-Martinez, Linda Ogilvie, Chuck Humphrey, Robert Armstrong

Paediatrics and Child Health, East Africa

Background and study aims: Data from the New Canadian Children and Youth Study (NCCYS), a national study of immigrant children and youth in Canada, are used to examine the mental health salience of putatively universal determinants, as well as of immigration-specific factors. Universal factors (UF) include age, gender, family and neighbourhood characteristics. Migration-specific (MS) factors include ethnic background, acculturative stress, prejudice, and the impact of region of resettlement within Canada.

Methods: In a sample of children from Hong Kong, the Philippines and Mainland China, the study examined the determinants of emotional problems (EP), and physical aggression (PA). A two-step regression …

Blepharophimosis-Ptosis-Epicanthus Inversus Syndrome In A Pakistani Pedigree, Tanveer Anjum Chaudhry, Mirza Umair Khalid, Taimur Saleem, Khabir Ahmad

Section of Ophthalmology

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare developmental ocular disorder. We report this condition affecting 4 members of a Pakistani family across three generations. A 2-year-old girl was brought to the clinic by her father for the correction of her shortened palpebral fissures. Examination findings were consistent with BPES. The girl's father, paternal grandfather and paternal aunt also had identical features. The distance between the medial canthi of the index case was 30 mm, and the lengths of vertical and horizontal palpebral fissure were 6 mm and 20 mm, respectively. BPES must be considered an important differential diagnosis in patients …

Evaluation Of Concurrent Medications Pre- And Post Initiation Of Long-Acting Injectable Antipsychotic Therapy, Lindsay Pokallus Pharmd, Laurence Karper Md, Jessica Price Pharmd, Bcps

Department of Pharmacy

No abstract provided.

Diverticular And Aneurysmal Structures Of The Left Ventricle In Adults: Report Of A Case Within The Context Of A Literature Review., Premraj Makkuni, Morris N Kotler, Vincent M. Figueredo

Department of Medical Genetics Faculty Papers

Left ventricular outpouchings are increasingly detected on cardiovascular imaging. Herein, we describe the case of a 45-year-old man who underwent noncardiac preoperative imaging and was found to have an asymptomatic left ventricular outpouching. The patient underwent successful surgical repair of the structure. When left ventricular outpouchings are detected, the main differential diagnoses are pseudoaneurysm, aneurysm, and diverticulum. The outcomes for these conditions differ substantially, and accurate diagnosis can be crucial in making clinical decisions. We review the relevant medical literature, outline the natural history of these left ventricular abnormalities, and discuss options in regard to their management.

Mechanism Of Catch Force: Tethering Of Thick And Thin Filaments By Twitchin., Thomas M Butler, Marion J Siegman

Department of Molecular Physiology and Biophysics Faculty Papers

Catch is a mechanical state occurring in some invertebrate smooth muscles characterized by high force maintenance and resistance to stretch during extremely slow relaxation. During catch, intracellular calcium is near basal concentration and myosin crossbridge cyctng rate is extremely slow. Catch force is relaxed by a protein kinase A-mediated phosphorylation of sites near the N- and C- temini of the minititin twitchin (approximately 526 kDa). Some catch force maintenance car also occur together with cycling myosin crossbridges at submaximal calcium concentrations, but not when the muscle is maximally activated. Additionally, the link responsible for catch can adjust during shortening of …

Differential Impact Of Tumor Suppressor Pathways On Dna Damage Response And Therapy-Induced Transformation In A Mouse Primary Cell Model., A Kathleen Mcclendon, Jeffry L Dean, Adam Ertel, Erik S Knudsen

Department of Cancer Biology Faculty Papers

The RB and p53 tumor suppressors are mediators of DNA damage response, and compound inactivation of RB and p53 is a common occurrence in human cancers. Surprisingly, their cooperation in DNA damage signaling in relation to tumorigenesis and therapeutic response remains enigmatic. In the context of individuals with heritable retinoblastoma, there is a predilection for secondary tumor development, which has been associated with the use of radiation-therapy to treat the primary tumor. Furthermore, while germline mutations of the p53 gene are critical drivers for cancer predisposition syndromes, it is postulated that extrinsic stresses play a major role in promoting varying …

Overview Of Surgical Management Of Infectious Non-Suppurative Brain Lesions (Part 2), Muhammad Shahzad Shamim, Ather Enam, Syed Faizan Ali, Rushna Pervez Ali, Mohammad Wasay

Section of Neurosurgery

No abstract provided.

Essential Medicines Management During Emergencies In Pakistan, S. K. S. Bukhari, J.A.R. H. Qureshi, Rashid Jooma, K.M. Bile, G. N. Kazi, W. A. Zaibi, A. Zafar

Section of Neurosurgery

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan's 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level …

Knowledge Attitude And Practices Of Undergraduate Students Regarding First Aid Measures, Afrasyab Khan, Sumaira Shaikh, Fawad Shuaib, Ahsan Sattar, Saira Aziz Samani, Quratulain Shabbir, Ameer Zaighum Rasheed

Department of Emergency Medicine

OBJECTIVES: To assess knowledge, attitude and practices of first aid measures in undergraduate students of Karachi.

METHODS: A cross-sectional study was carried out at six colleges of Karachi, three of which were medical colleges and three non-medical colleges. Knowledge was assessed regarding various emergency situations with the help of a questionnaire. The target population size was 460, based on 50% prevalence and 95% confidence interval. The eventual sample size achieved was 446.

RESULTS: A total of 446 students were interviewed. Seventy eight students (17.5%) had formal First Aid (FA) training. The mean number of correct answers of students with FA …

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …

Synergistic Effects Of Garcinol And Gemcitabine In Enhancing Therapeutic Efficacy In Pancreatic Adenocarcinoma Cells And Its Effect On Microrna Profile, Mansi Anand Parasramka

Wayne State University Dissertations

SYNERGISTIC EFFECTS OF GARCINOL AND GEMCITABINE IN ENHANCING THERAPEUTIC EFFICACY IN PANCREATIC ADENOCARCINOMA CELLS AND ITS EFFECT ON MICRORNA PROFILE

By

MANSI PARASRAMKA

ADVISOR: DR. SMITI V. GUPTA

MAJOR: NUTRITION AND FOOD SCIENCE

DEGREE: DOCTOR OF PHILOSPHY

Human Pancreatic Cancer (PaCa) is one of the most hostile and fourth leading cause of cancer deaths in the United States. Current standard chemotherapeutic agent for advanced PaCa is gemcitabine, a cytotoxic nucleoside analogue which results in modest response due to high degree of inherent and acquired chemo resistance. Forthcoming evidence strongly supports that non-nutritive food components have therapeutic benefits attributable to pleiotropic …

Hepatitis C In Pakistan - A Neglected Challenge, Waris Qidwai, Ammad Fahim, Shahan Waheed

Department of Family Medicine

No abstract provided.

Role Of Transforming Growth Factor Beta In Corneal Function, Biology And Pathology, Ashish Tandon, Jonathan C. K. Tovey, Ajay Sharma, Rangan Gupta, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Transforming growth factor-beta (TGFβ) is a pleiotropic multifunctional cytokine that regulates several essential cellular processes in many parts of the body including the cornea. Three isoforms of TGFβ are known in mammals and the human cornea expresses all of them. TGFβ1 has been shown to play a central role in scar formation in adult corneas whereas TGFβ2 and TGFβ3 have been implicated to play a critical role in corneal development and scarless wound healing during embryogenesis. The biological effects of TGFβ in the cornea have been shown to follow SMAD dependent as well as SMAD-independent signaling pathways depending upon cellular …